Glaucoma Dotaz Zobrazit nápovědu
- Klíčová slova
- CHLORPROMAZINE/therapy *, GLAUCOMA/therapy *,
- MeSH
- chlorpromazin terapie MeSH
- glaukom s uzavřeným úhlem * MeSH
- glaukom terapie MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- chlorpromazin MeSH
Secondary uveitic glaucoma is a serious sight-threatening complication of intraocular inflammation (uveitis). It develops in approximately 10-20% of patients with uveitis (although this figure may be higher depending on the type of inflammation). It is more commonly associated with chronic forms of uveitis, especially anterior uveitis. Elevation of intraocular pressure (IOP) and the development of secondary glaucoma arise as a direct or indirect consequence of uveitis, and may develop further in association with therapy for intraocular inflammation. Several types of uveitic glaucoma are distinguished according to the mechanism of development: open-angle secondary glaucoma (including steroid-induced secondary glaucoma), angle-closure secondary glaucoma, and a combination of both. It is necessary to determine the pathogenesis of uveitis and target the treatment of the inflammatory process according to it. Subsequently, it is necessary to determine the type of secondary glaucoma, which influences the choice of therapy. Compensation for IOP should be achieved as quickly as possible, before irreversible damage to the optic nerve and visual field occurs. In the first instance, we choose conservative pharmacological therapy. However, this therapy fails more often in secondary uveitic glaucoma than in primary open-angle glaucoma. For this reason, surgical or laser therapy is necessary for refractory glaucoma. Trabeculectomy remains the gold standard in surgical therapy for secondary uveitic glaucoma, but other surgical techniques can also be used (Ahmed drainage implants, goniotomy in the paediatric population, surgical iridectomy, and synechiae for angle closure etc.). The choice of method is individualised according to the clinical findings of the patient and previous ocular procedures. However, the main factor influencing the success and efficacy of filtration surgery is adequate therapy and control of the intraocular inflammatory process.
- Klíčová slova
- Uveitis, secondary uveitic glaucoma, therapy of secondary uveitic glaucoma, uveitis,
- MeSH
- dítě MeSH
- glaukom s otevřeným úhlem * MeSH
- glaukom s uzavřeným úhlem * MeSH
- glaukom * MeSH
- lidé MeSH
- nitrooční tlak MeSH
- trabekulektomie * MeSH
- zánět MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: Topamax (topiramate) is a drug used in the treatment of epilepsy or migraine. Its use may rarely be associated with the occurrence of secondary angle-closure glaucoma due to supraciliary effusion. Although the ocular finding resembles primary angle-closure glaucoma, bilateral infliction should always raise the suspicion that it is drug-induced glaucoma. CASE REPORT: The authors present a case of a 51-year-old patient on Topamax therapy with sudden vertigo, headache and blurred vision. Ophthalmic examination revealed bilateral angle-closure glaucoma, which was initially treated in the classical manner by administration of local antiglaucoma drugs and pilocarpine, followed by administration of osmotically active substances and laser iridotomy. Only the subsequent discontinuation of Topamax and the use of local cycloplegics and corticosteroids led to the release of the anterior segment angle closure and normalization of intraocular pressure. CONCLUSION: The indicating physician and ophthalmologist must be aware of the possible side effects of Topamax therapy to determine the correct diagnosis and to administer treatment appropriately.
- Klíčová slova
- Epilepsy, Migraine, acute myopia, angle-closure glaucoma, epilepsy, migraine, topamax, topiramate,
- MeSH
- fruktosa škodlivé účinky MeSH
- glaukom s uzavřeným úhlem * chemicky indukované diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- nitrooční tlak MeSH
- tonometrie oční MeSH
- topiramat škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- fruktosa MeSH
- topiramat MeSH
PURPOSE: To report a case of patient with Miller Fisher syndrome, complicated by simultaneous bilateral acute angle-closure glaucoma in her slightly (+1.5) hyperopic eyes. METHODS: We present a case report of a 71-year-old female patient presenting with total ophthalmoplegia, areflexia, ataxia and bilateral acute angle-closure glaucoma. RESULTS: The initial ocular examination revealed hand motion in the both eyes and oedematic corneas. Initial intraocular pressure was immeasurable high (measurment by Tonopen Avia). Measurement was possible after intravenous Mannitol 20 % infusion on both eyes as 54 and 56 mm Hg, respectively. Local medical therapy of pilocarpine, timolol, dorsolamide and dexamethasone improve intraocular pressure into normal limits within several hours. Prophylactic peripheral Nd-YAG laser iridotomy was performed on a both eyes two days later. Systemic treatment involved plasma exchange and rehabilitation program. Subsequent cataract surgery on both eyes with posterior capsule lens implantation improve the best corrected visual acuity on right eye from 0.5 to 1.0 and the left eye from 0.5 to 0.8, respectively. Intraocular pressure is within normal limits without any glaucoma therapy. Follow up period is three years. CONCLUSIONS: This is the second reported case of patient with Miller Fisher syndrome and simultaneous bilateral acute angle-closure glaucoma and the fifth reported case of Miller Fisher syndrome and acute angle-closure glaucoma. Treatment for both conditions made a very good recovery.
- Klíčová slova
- Miller Fisher syndrome, acute angle-closure glaucoma, bilateral acute angle-closure glaucoma,
- MeSH
- glaukom s uzavřeným úhlem komplikace terapie MeSH
- laserová terapie * MeSH
- lidé MeSH
- Miller Fisherův syndrom komplikace MeSH
- nitrooční tlak MeSH
- senioři MeSH
- tonometrie oční MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
PURPOSE: The aim of our study was to find out whether in patients with hypertensive glaucoma (HTG) and normotensive glaucoma (NTG), there is a change in the size of the chiasm depending on the changes in the visual field. Therefore, we retrospectively measured the width of the chiasm in the patients to whom we measured the size of the corpus geniculatum laterale in 2013. MATERIALS AND METHODS: The group consisted of two groups of patients. Nine with hypertensive glaucoma (HTG) and nine with normotensive glaucoma (NTG). The diagnosis was based on a complex ophthalmological examination and in NTG and electrophysiological examination. The visual field was examined by a rapid threshold program on the Medmont M700. The sum of the sensitivity from both visual fields in the range of 0-22 degrees was compared with the width of the chiasm obtained by the magnetic resonance imaging using the eight channel head coil. The measured values of all subjects were analyzed using a paired t-test and a correlation coefficient. RESULTS: We found a reduction in the chiasma width in both glaucoma groups. We found a statistically significant difference in the size of the chiasm (p = 0.0003) between the control group and the HTG group (p = 0.001). The narrowing of the chiasm showed a slight correlation in HTG with changes in the field of vision (r = 0.139) and in NTG a moderate correlation (r = 0.375). CONCLUSION: We found a reduction in the size of the chiasm in both HTG and NTG. The sum of sensitivities in the central parts of the visual field, however, more correlated with the reduction in the size of the chiasm in NTG. This finding shows that there are two different diagnostic groups.
- Klíčová slova
- Hypertensive glaucoma, MRI, changes in visual field, normotensive glaucoma, optic chiasm width,
- MeSH
- chiasma opticum diagnostické zobrazování MeSH
- discus nervi optici * MeSH
- glaukom s otevřeným úhlem * MeSH
- glaukom * MeSH
- lidé MeSH
- nitrooční tlak MeSH
- optická koherentní tomografie MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The purpose of the study was to evaluate influence of betaxolol, brimonidine and carteolol in the progression of the visual field defects during time at patients with normotensive glaucoma (NTG). MATERIALS AND METHODS: This study included (60 eyes of) 30 patients with NTG. First group consisted of 20 eyes of 10 patients of the average age of 58.5 years, who were treated by betaxolol. Second group also consisted of 20 eyes of 10 patients of the average age of 62.6 years and they were treated by brimonidine. Third group had the same count of the eyes and patients, the average age was 61.1 years and these patients were treated by carteolol. Diagnose of NTG was based on the comprehensive ophthalmological examination including electroretinography and visual evoked potentials. Visual fields were examined by fast threshold glaucoma test using Medmont M700 device. We compared pattern defect (PD) in the visual field for 3 years. The including criteria were: similar visual field findings at the beginning of the study, stable eye therapy (treatment was not changed during the study), uncorrected or best corrected (up to +-3 D) visual acuity of 1,0 of ETDRS, intraocular pressure between 10-15 mm Hg, if present, then compensated cardiovascular disease, no other internal or neurological disorders. RESULTS: We didnt notice any statistically important difference of PD. The study revealed that brimonidin (p=0,99) and betaxolol (p = 0,81) had the best effect. CONCLUSION: Local therapy of betaxolol, brimonidine and carteolol has an essential clinical value in normotensive glaucoma. All the mentioned treatments had a protective effect on the visual field. However, local side-effects of brimonidinu are a question.
- Klíčová slova
- betaxolol, brimonidin, brimonidin and carteol treatment, normotensive glaucoma, pattern defect,
- MeSH
- betaxolol MeSH
- glaukom s otevřeným úhlem * MeSH
- glaukom * MeSH
- karteolol * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nitrooční tlak MeSH
- zrakové evokované potenciály MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- betaxolol MeSH
- karteolol * MeSH
Our group of 200 with laser treated diabetics included 5 patients (2.5%) with bilaterally treated primary simple glaucoma. All of them had diabetic maculopathy exclusively within the range of simple diabetic retinopathy. The focal type of maculopathy occurred 5 times, the cystoid 3 times, the ischemic once. There was emphasized the necessity to devote increased care to diabetics with glaucoma because for them glaucoma represents a risk factor regarding the further development of the visual function and the extent of the visual field. On the other hand, the decreased foveolar sensitivity in some diabetics with glaucoma may reduce the visual acuity which thus becomes an unreliable criterion of the success of the laser therapy.
- Klíčová slova
- ALLERGY/complications *, CATARACT/complications *, GLAUCOMA/complications *,
- MeSH
- alergie komplikace MeSH
- glaukom s otevřeným úhlem * MeSH
- glaukom komplikace MeSH
- katarakta komplikace MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- GLAUCOMA *, GONIOSCOPY *,
- MeSH
- glaukom * MeSH
- gonioskopie * MeSH
- lidé MeSH
- Tetrahymenina * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
AIM: Mutations in the myocilin gene (MYOC) cause trabecular dysfunction and thus are involved in the pathogenesis of primary open-angle glaucoma (POAG). The aim of this study was to characterize and describe the clinical findings in two Czech families with POAG due to pathogenic variants in the MYOC gene. MATERIAL AND METHODS: Members of the two families affected by POAG underwent complete ophthalmological examination. In the proband from the first family, a direct sequencing of the three most frequent mutations in the MYOC gene was performed, and in the proband from the second family, an exome sequencing was performed. Other family members underwent targeted tests using direct sequencing. RESULTS: In total, 10 individuals diagnosed with POAG aged 20-70 years (mean 32.2 years, SD ±10,9 years) were examined. Eight of them showed advanced glaucomatous neuropathy with severe changes in the retinal nerve fiber layer. Clinical signs of POAG were present in six individuals in the third decade of life already; another four developed POAG during the fourth decade of life. Eight out of 10 patients had to undergo filtration surgery. Surgery was performed within 1 to 7 years of diagnosis, but mostly was performed within 2 years of glaucoma diagnosis. In the first family, MYOC variant c.1099G>A p.(Gly367Arg) was shown in the affected family members; in the second family MYOC variant c.1440C>A p.(Asn480Lys), both in heterozygous state. The changes were assessed as pathogenic. CONCLUSION: Our study is the first to describe mutations in the MYOC gene causing POAG in Czech patients. Genetic testing may be recommended for this diagnosis, especially in individuals with early presentation and a positive family history. Carriers of pathogenic variants of the MYOC gene have a lifetime risk of developing POAG of more than 50% and the course of their disease is often more aggressive, requiring surgical intervention to permanently control the intraocular pressure.
- Klíčová slova
- Mutation, Myocilin, juvenile glaucoma, mutation, primary open angle glaucoma,
- MeSH
- glaukom s otevřeným úhlem * diagnóza genetika MeSH
- lidé MeSH
- mutace MeSH
- nitrooční tlak MeSH
- oční proteiny genetika MeSH
- rodokmen MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- oční proteiny MeSH
